5 2 13 4 DC B38 (8 78)
26 5 68 8 BROWN & WILLIAMSON TOBACCO CORPORATION LOUISVILLE, KENTUCKY 40201
32 10 62 11 SPECIAL SAMPLE MANUFACTURE
63 10 65 11 ☑
53 12 65 13 SHIPMENT ☐
53 14 65 15 TRANSFER ☐
40 16 65 18 REDUCED TO MATERIAL ☐
5 16 17 18 Copies to:
80 18 86 20 6/ 25/ 81
57 18 74 20 Date of Request
16 19 37 25 Factory Cost Dept. Writer Development Center Sue Livesay
57 20 73 21 Account Number
78 20 86 21 22 244 00
5 33 26 35 Sample Disposition
38 38 58 41 Quantity, Cartons of 200 each
72 38 86 41 Tax Status Paid or Free
7 42 24 44 To Sample Stock
12 45 16 46 R & D
45 45 47 46 20
76 45 80 47 Free
13 48 17 49 M. R.
7 54 27 56 Method of Shipment
4 59 28 60 Cigarette Description
16 63 66 67 KS 1 mg grooved product using 4. 3/ 37 filter material. Cigarette code 244131
4 71 40 73 Special Instructions & Comments
66 84 81 86 620745255
4 89 21 91 Completion Date
29 89 35 90 6/ 25/ 81
55 89 62 91 Signed
67 89 79 91 B. D. WINGLER
